Erectile dysfunction (ED) is a medical condition when a man is unable to achieve or […]
Obesity has become a common global public health concern that affects both children and adults for the past few decades.
The incidence of obesity is also on the rise in Singapore. According to the National Population Health Survey 2021/2022, obesity affects 13.1% of males and 10.2% of females [1]. The causes of excessive weight gain tend to be multifactorial, a combination of genetic predisposition, physical activity levels, sleeping patterns, and eating habits.
In this article, we explore the effect of obesity on sexual health and discuss medical options that can be offered to address this rising concern.
Research has shown that the physiological state of an obese person can impact a person’s sexual function [2].
Females
In obese women, a normal menstrual-ovulation cycle can be affected due to a persistent hyperandrogenic state – a body physiological state where one has excessive male hormones [3]. The level of sex-hormone binding globulin (SHBG) is lesser, while male hormones, such as testosterone, dihydrotestosterone, and androstenediol, can be much higher. Obesity is also associated with clinical symptoms such as menstrual abnormalities, reduced libido, and urinary incontinence in females as an effect of hormonal dysregulation.
Males
Ironically, in men, obesity is associated with reduced testosterone due to the aromatisation of excessive fat (adipose) tissues into estradiol (a type of female hormone) [4]. The tilt of hormonal equilibrium causes men with obesity to have reduced libido and erectile dysfunction.
Both females and males
As the body of a person with obesity is always in a ‘physiological inflammatory state’, the oxidative stress can impair both sperm and ovum qualities [5], leading further to infertility issues [6].
A person with obesity has a higher risk of cardiovascular chronic disease [7], including diabetes [8].
In poorly controlled diabetes, blood vessels and nerve endings can be affected, leading to poor circulation of the genital region. This can present itself with sexual dysfunction symptoms such as physical disability such as the inability to erect in males and the inability to enjoy sexual experiences in both males and females.
Over time, excessive weight bearing can be associated with general physical limitation, chronic fatigue, and predisposition to arthritic symptoms such as joint aches and pain [9].
Obesity is also known to correlate with an increased risk of cardiovascular and metabolic disorders. Obesity increases the chance of developing heart disease, hypertension, high cholesterol, type-2 diabetes, and even cancers [10].
Side effects of medications from chronic conditions, such as anti-hypertensives [11] and diabetes medications [12], can lead to sexual dysfunction and reduced libido, hence indirectly affecting a person’s sexual well-being.
Clinical studies have shown the correlation between obesity and mental health disorders such as anxiety and depression [13]. These mood disorders can have a negative impact on a person’s sexual relationship with others. One can be disinterested in sexual activities, having poor libido and unable to enjoy their sexual life.
One might also have lower self-esteem and be embarrassed about their body image, hence having lower sexual confidence and dissatisfaction with their sexual life.
Weight management should be a holistic approach. Medical management of weight loss with prescription drugs should be followed by a targeted, realistic eating plan and consistent, achievable physical activities to achieve the target weight and maintain that ideal weight.
Healthy eating
Make clever decisions when choosing food options and quantity to ensure balanced nutrients are acquired yet not overeating.
Physical activities
Regular physical activity helps lower weight and achieve a healthy weight. Staying motivated and consistent with your physical regimen is key to achieving and maintaining your target weight in the long run.
Being creative and engaging in physical activities are useful to stay motivated and consistent with your exercise.
Most people struggle with long-term weight loss. Many may have tried to lose weight, only to regain it as time passed. Medical treatment of weight management can address this concern effectively and safely.
Weight Loss Injections
Under the guidance of your prescribing medical practitioner, these weight loss injections can be titrated safely and effectively to reduce a person’s weight. Clinical studies over three years in patients who are on the medication show that 56% of patients can lose significant weight at the 1-year mark of taking the medication [14].
What have I learnt today?
If you have concerns about your weight, you are encouraged to reach out to your trusted physician to learn more about the medical management of weight control.
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Obesity is defined as having an excess amount of fat in your system.